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Varicose veins, Phlebitis, Cellulitis

Lower Extremity Venous Reflux
( Venous Insufficiency/ Lower Extremities Vein Mapping)   

venous reflux ultrasound is a noninvasive test that uses high-frequency sound waves to examine the valves in the veins. It's also known as a venous insufficiency study or venous incompetence study. 

The test is used to diagnose venous reflux, which occurs when blood flow from the veins in the legs and feet is impaired. Symptoms include: 

Swollen legs, Varicose veins, Skin breakdown, Ulcers, Aching, Burning, Heaviness, Cramping, Fatigue, Itching. 

A complete study typically takes 30 to 60 minutes and may include both lower extremities. No special preparation is required.

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Vein mapping is a procedure that uses ultrasound imaging to create a map of your blood vessels. 

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  • Wear comfortable, loose-fitting clothing

  • Remove all clothing and jewelry in the area to be examined

Venous Inseficiency Ultrasound
DVT Exam
Swollen ankle Treatment

Lower Extremity Venous
(DVT Rule Out)  

Venous ultrasound is the most common reason for a venous ultrasound exam is to search for blood clots, especially in the veins of the leg. This condition is often referred to as deep vein thrombosis or DVT. These clots may break off and pass into the lungs, where they can cause a dangerous condition called pulmonary embolism. If the blood clot in the leg is found early enough, treatment can be started to prevent it from passing to the lungs.

Ankle-brachial Pressure Exam (ABI)

ABI ( Ankle/Brachial Pressure)

1-Noninvasive physiologic studies of upper or lower extremity arteries, single level, bilateral (e.g., ankle/brachial indices, Doppler waveform analysis.

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2-Noninvasive physiologic studies of upper or lower extremity arteries, multiple levels or with provocative functional maneuvers, complete bilateral study (e.g., segmental blood pressure measurements, segmental.
Doppler waveform analysis, segmental Volume plethysmography, segmental transcutaneous охуgеn tension measurements, measurements with postural provocative tests, measurements with reactive hyperemia).

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3-Noninvasive physiologic studies of lower extremity arteries at rest and following treadmill stress testing (i.e., bidirectional Doppler waveform or volume plethysmography recording and analysis at rest with ankle/brachial indices immediately after and at timed intervals following the performance of a standardized protocol on a motorized treadmill plus recording of the time of onset of claudication or other symptoms, maximal walking time, and time to recovery) complete bilateral study.

Ankle-brachial Pressure Exam (ABI)
Hand Vascular

Upper Extremities Preoperative assessment of blood vessels for dialysis access

A preoperative assessment for dialysis access in the upper extremities may include: 

  • Pulse examination

  • Differential pressure

  • Palmar arch patency

  • Arterial size

  • Duplex ultrasound of the arm veins

The axillary, brachial, radial, and ulnar pulses should be examined in both upper extremities. The quality of these pulses should be scored as either normal, diminished, or absent. 

A duplex ultrasound of the arm veins is done to look for veins of suitable size to use. The arteries are also assessed to ensure that they are of adequate size, free from disease, and will provide adequate "inflow" to the fistula once formed. 

The first step in getting vascular access is having a special study that is called Vein mapping or Vessel mapping. This ultrasound study measures the blood flow in your blood vessels (arteries and veins) in your arms. 

Hand Arteries
Numbness of the hands

Upper Extremities Vein Mapping

Vein mapping is a painless ultrasound procedure that maps the veins in your upper or lower extremities. The procedure uses sound waves to create a picture of your blood vessels. This helps your doctor see the size, depth, and flow of blood in your veins.

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During the procedure, a technologist will apply a warm gel to your arm and use a transducer to examine your veins. You might hear the sound of moving blood. The procedure takes about 60 minutes. 

A doctor can use the results of a vein mapping procedure to: 

  • Plan treatment

  • Check for health conditions

  • Diagnose chronic venous insufficiency

  • Diagnose deep vein thrombosis

  • Guide medical procedures

Pain Hand
Upper Extremeties Ultrasound

Upper Extremities Venous

The upper limb's venous system drains deoxygenated blood from the hand, forearm, and arm back to the heart. The veins of the upper limb are divided into two systems: 

  • Superficial veins

    Drain blood from the skin and superficial fascia.

    The main superficial veins include:

    • Cephalic

    • Basilic

    • Median cubital

    • Accessory cephalic

LA Physicians Medical Group Vascular Ultrasound
LA Physicians Medical Group Vascular Ultrasound

Upper Extremities Arterial

An upper extremity arterial ultrasound is a safe and painless procedure that uses ultrasound to image the arteries in your arms. It can evaluate the blood flow and determine if there are any blockages or narrowings in the arteries. 

During the procedure, a technician will: 

  1. Apply gel to your arms

  2. Place an ultrasound probe on your skin

  3. Send sound waves through the gel and into your body

The procedure takes about 30 minutes for each arm. 

LA Physicians Medical Group Vascular Ultrasound
Renal Arteries

Renal Vasculature

Duplex and color Doppler ultrasound are utilized to evaluate a number of vascular diseases of the kidneys. The location of the renal vessels and the wide variation in the anatomy and physiology of the renal vessels can make the examination challenging and difficult to master. This chapter will provide a thorough review of all aspects of Doppler ultrasound in the assessment of the renal arteries and veins. The anatomy and principles of sonographic examination of the native renal vessels are considered first, followed by a discussion of renal vascular disorders, with special emphasis on renal artery stenosis and occlusion, and the renal vasculature assessment postintervention. Key features in the diagnosis of renal arterial aneurysms, arteriovenous fistulas (AVF), arteriovenous malformations (AVMs), renal vein thrombosis, and renal masses with tumor invasion of the renal veins will also be reviewed.

Renal Arterial and Venous flow
LA Physicians Medical Group Vascular Clinic

Echocardiogram

An echocardiogram, often referred to as a cardiac echo or simply an echo, is a sonogram of the heart. (It is not abbreviated as ECG because that is an abbreviation for an electrocardiogram.) Echocardiography uses standard two-dimensional, three-dimensional, and Doppler ultrasound to create images of the heart.

Echocardiography has become routinely used in the diagnosis, management, and follow-up of patients with any suspected or known heart diseases. It is one of the most widely used diagnostic tests in cardiology. It can provide a wealth of helpful information, including the size and shape of the heart (internal chamber size quantification), pumping capacity, and the location and extent of any tissue damage. An echocardiogram can also give physicians other estimates of heart function, such as a calculation of the cardiac output, ejection fraction, and diastolic function (how well the heart relaxes).

Echocardiography can help detect cardiomyopathies, such as hypertrophic cardiomyopathy, dilated cardiomyopathy, and many others. The use of stress echocardiography may also help determine whether any chest pain or associated symptoms are related to heart disease. The biggest advantage to echocardiography is that it is not invasive (does not involve breaking the skin or entering body cavities) and has no known risks or side effects.

Not only can an echocardiogram create ultrasound images of heart structures, but it can also produce an accurate assessment of the blood flowing through the heart by Doppler echocardiography, using pulsed- or continuous-wave Doppler ultrasound. This allows the assessment of both normal and abnormal blood flow through the heart. Color Doppler, as well as spectral Doppler, is used to visualize any abnormal communications between the left and right sides of the heart, any leaking of blood through the valves (valvular regurgitation), and estimate how well the valves open (or do not open in the case of valvular stenosis). The Doppler technique can also be used for tissue motion and velocity measurement by tissue Doppler echocardiography.

Transthoracic echocardiogram (TTE)
Carotid Ultrasound LA Physicians Medical Group Vascular

Carotid

A carotid ultrasound is a noninvasive, painless procedure that uses sound waves to create images of the carotid arteries in the neck.  The carotid arteries carry blood from the heart to the brain.  A carotid ultrasound can show if plaque buildup has narrowed the carotid arteries, which can reduce blood flow to the brain. This can increase the risk of stroke.

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These risk factors include: 

  • High blood pressure

  • An abnormal sound in the carotid artery called a carotid bruit

To prepare for a carotid ultrasound, you can: 

  • Avoid smoking or drinking caffeine within two hours of the test

  • Wear loose clothing or clothing with an open-neck

  • Remove jewelry

The doctor who ordered the test will receive the results within two to three days. 

Symptoms of a blocked carotid artery include: 

  • Blurred or lost vision

  • Confusion

  • Memory loss

  • Numbness or weakness in one side of the body

  • Problems with thinking, reasoning, memory, and speech

Carotid Ultrasound LA Physicians Medical Group Vascular
Carotid Ultrasound LA Physicians Medical Group Vascular

Lower Extremity Arterial 

Doppler ultrasonography of the lower extremity arteries is a valuable technique, although it is less frequently indicated for peripheral arterial disease than for deep vein thrombosis or varicose veins. Ultrasonography can diagnose stenosis through the direct visualization of plaques and through the analysis of the Doppler waveforms in stenotic and poststenotic arteries. To perform Doppler ultrasonography of the lower extremity arteries, the operator should be familiar with the arterial anatomy of the lower extremities, basic scanning techniques, and the parameters used in color and pulsed-wave Doppler ultrasonography.

Using gray-scale technique, a significant atherosclerotic vascular lesion can be detected only by thickening of the vessel wall or segmental narrowing of the lumen (which usually represents plaque or mural thrombus). Aneurysms and intimal flaps may also be identified.

Lower-extremity peripheral arterial disease (LE PAD) is often diagnosed by using US, which depicts a change in the flow pattern on Doppler spectrum imaging. Proximal to the lesion, the flow pattern is normal. At the stenosis, the peak systolic velocity increases in proportion to the degree of stenosis. The diastolic portion of the Doppler waveform depends on the artery distal to the lesion and the severity of the lesion. Diastolic flow may be significantly increased or absent. Systolic velocity distal to the lesion is equal or lower than the velocity proximal to the stenosis.

The absence of a flow signal may represent occlusion, vascular calcifications, or technical error. Thrombosis is usually seen as echogenic material in the artery. Large collateral branches are likely to indicate high-grade stenosis or more distal occlusion.

A thorough examination provides information about the entire common femoral, superficial femoral, and popliteal arteries. Examination of the deep femoral and tibial vessels is usually limited.

Multiple published studies evaluated the femoropopliteal segment. The reported sensitivity was more than 85%, and the specificity was more than 92% in detecting segmental arterial lesions.

Venous Insufficiency Ultrasound LA Physicians Medical Group Vascular
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